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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8657 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />! �� � "1 L�✓ �-.1 m: �.r t_- %ir _ <br />PROJECT ADDRESS <br />iI �-(�-0 `� <br />� oq �r���5 <br />� .�.�� � v i� E � <br />Owne� Mail Address Cdy StateZp Phone <br />:-�, � �GINa'� � �i ��, �,J, i yl'1vh--�� �-_— <br />Tonanl Mafi Address City StatelZip Phone <br />?J :�. � 7 > �7'7 � <br />C u:- �(t ��'J .S� <br />Elr.ctrical �raclor � Mall Address <br />� T 1= �� �'� � r�. l� !� 1 <br />Slata Lir.ense �umber <br />Proposed Use of [3uilding <br />�escriplion of Work to Be Done: <br />NOTE: WIRING IN NON-DWELLINGS IS RE�UIRED TO <br />[3E IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />c�y <br />_Fa <br />� I.t� �'I � I'T� <br />State2ip Phonc <br />.�3-z�'�- <br />Conlracl Price ol W �rk <br />�{{I l.)`p�q Y!%iV� ��-i� Z�/_� S�`i <br />Conlacl PersoN (Plan Review) <br />1 hmeby ceAily (hat 1 hove roaA and exmnined this applicafion and know fhe sarne fo be frve and <br />conr,r.f. All provisions o; laws and ordinances govamng this type o! work will be wmpleted <br />whe(hur speulied hcrein o. noL The grantino o! a peimrf dor.s nol presume to give aulhonry fo <br />violate or cancel fhe provisions otany ofher sfele or local low regulating construcfion or Ihe <br />p�dnrmance nlconst�ur.hon. Thaf I am aulhorized by Ihe owrter o/ fhis property fo pedorm the <br />worh lor which applicafion is made antl 1 compry wnr� u�e s�ere cunnu�rors �aw �0.27 RCW and <br />29G.200 N�AC. <br />/.� "/ Z -C <br />FEE <br />�c�'r ll ' � U`� <br />